Surgical Management of Uveitis-Glaucoma-Hyphema Syndrome

Monday, April 20, 2015: 1:42 PM
Room 1A (San Diego Convention Center)
Moness Masri, MD
Tessa A. Weinberg
Xavier Campos-Möller, MD
Chris J. Rudnisky, MD MPH
Jay Ching Chieh Wang, MD
Ike K. Ahmed, MD

Purpose
To report the results of IOL repositioning or exchange with or without adjunctive glaucoma surgery for the management of UGH syndrome.

Methods
Retrospective consecutive case series of patients undergoing IOL exchange or repositioning for UGH syndrome.  Adjunctive glaucoma surgeries were recorded. Primary outcome measure was resolution of UGH syndrome. Secondary outcome measures were changes in IOP, glaucoma medications, uncorrected and corrected distance visual acuity (UDVA, CDVA), and complications.

Results
We included 23 eyes of 22 patients with an average follow-up of 18 months (range = 3- 66 months). 19 IOLs were exchanged, 10 of which had adjunctive glaucoma surgery and 4 IOLs were repositioned.  For all eyes, 70% had complete resolution, 26% had partial resolution, and 4% did not resolve. Mean IOP (mmHg) decreased from 19.8 ± 6.39 preoperatively to 14.87 ± 4.65 postoperatively (p = 0.012). Mean number of glaucoma medications decreased from 1.3 ± 1.3 to 0.7 ± 0.9 (p = 0.023). Mean LogMAR CDVA was 0.40 ± 0.37 preoperatively and 0.24 ± 0.20 postoperatively (p= 0.178).

Conclusion
The majority (96%) of patients undergoing IOL exchange or repositioning for the treatment of UGH syndrome had some degree of resolution. Overall IOP and number of glaucoma medications were lower postoperatively. There was no statistically significant change in CDVA.